Pre-employment physical capacity testing as a predictor for musculoskeletal injury in paramedics: A review of the literature.

BACKGROUND: Workplace injuries place a significant physical, social and financial burden on organisations globally. Paramedics provide emergency management of workplace injuries, and are subjected to heightened injury risk as a direct consequence of providing such care.

OBJECTIVE: This review aims to identify the current evidence reporting workplace musculoskeletal injury generally, and to relate this to pre-employment physical capacity testing within the paramedic industry specifically.

METHOD: A search of the electronic databases (Ovid Medline, Cochrane Database of Systematic Reviews, NIOSHTIC-2, RILOSH, CISDOC and HSELINE) was completed using the keywords musculoskeletal, workplace, injury, industrial, accident, pre-employment physical capacity testing, paramedic, emergency service employee, firefighter, and police. Articles were excluded if they did not describe pre-employment physical capacity testing, musculoskeletal injuries, or were not available in English.

RESULTS: The electronic literature search identified 765 articles, following application of exclusion criteria: based on title/abstract of article (669); no relevance (62) or unavailable in English (4), 30 articles were included in this review.The review identified that physical fitness, gender, age, equipment and demographic variables were key factors in the current high rate of paramedic workplace injury. However, there is little evidence available to quantify the relationship between pre-employment physical capacity testing and subsequent injury amongst the paramedic cohort.

CONCLUSION: Despite evidence suggesting that pre-employment physical capacity testing scores may be predictive of subsequent musculoskeletal injury in paramedics, there are currently no studies in this area. Quantifying the potential association between factors affecting the conduct of paramedic work and the type of injuries that result requires examination through future research.